Clinical Study Of The Relationship Between Hepatitis B Infection And The Incidence,treatment And Prognosis Of Lymphoma

Objective: Lymphoma is a large class of malignant tumors that originate in lymph nodes or lymph tissues,which mostly occur in people with abnormal immune function or immunodeficiency.Studies have shown that patients with diffuse large B cell lymphoma(DLBCL)have a higher infection rate with hepatitis B.This study systematically analyzed the relationship between hepatitis B infection and lymphoma pathology and clinical prognosis.Methods: A retrospective analysis of 742 patients with lymphoma admitted to Shaanxi Provincial People’s Hospital from January 2010 to October 2020,analysis of the infection rate of hepatitis B virus in patients with lymphoma,the relationship between virus B infection and lymphoma types,The adverse effects of treatment include the effects of transaminase in liver function and the prognosis of lymphoma.The overall survival(OS)follow-up period ends in December 2020.Using SPSS 26.0 statistical software analysis,the difference was statistically significant with P<0.05.Results:1.Among 742 cases of lymphoma,non-Hodgkin B cells accounted for 72.1%(535/742),of which DLBCL patients accounted for 43%(319/742),and non-Hodgkin NK/T cells accounted for 22.5%(167/742).2.516 patients with detailed information about hepatitis B virus infection were analyzed.Among them,HBV uninfected group(full negative group and only HBs Ab positive)accounted for 51.2%(264/516),and current infection group(HBs Ag positive)12%(62/ 516),36.8%(190/516)of the previous infection group(HBs Ag negative and HBc Ab positive).3.There were statistically significant differences in age(≥60 years)(χ2=11.725,P=0.001),spleen involvement(χ2=4.276,P=0.039)and HBV infection(current infection and previous infection).4.6.7%(17/252)(current infection and previous infection)had HBV activation during treatment,of which 70.6%(12/17)were current infections and only 29.4%(5/17)were past infections.Of the 17 HBV-activated cases,76.5%(13/17)died during the observation period,69.2%(9/13)died from lymphoma,and 30.8%(4/13)died from hepatitis B progression.5.Among the 405 lymphomas who received systemic chemotherapy,patients with HBV infection were more likely to have liver damage(52.6% and 57.6% of HBV uninfected and HBV infection,respectively,P=0.012).This result also occurred in 293 patients who received systemic chemotherapy for B-cell non-Hodgkin lymphoma(NHL)(HBV uninfected and HBV infection were 46.1% and 56.6%,P=0.009)and 178 received Systemic chemotherapy for DLBCL(HBV uninfected and HBV infected 42.0% and 59.8%,respectively,P=0.027),suggesting that the difference in liver function damage between the two groups during chemotherapy was statistically significant.6.During the treatment,4.8%(3/62)(current infection)progressed to hepatitis B progressing to severe hepatitis,3.2%(2/62)transformed into primary liver cancer,4 related deaths,HBV current infection caused 6.5%(4/62)patients died,and only 0.2%(1/454)of HBs Ag-negative patients died after they progressed to liver cancer.7.The median survival time of 516 patients with lymphoma was 61 months,and the median survival time of patients without HBV infection was 84 months,which was longer than that of patients with HBV infection of 49 months(P=0.022).According to pathological classification,the survival time of B-NHL patients in the HBV current infection group was 32 months significantly lower than that in the previously infected group and HBV uninfected group(the two were 65 months and 69 months,respectively,P=0.007 and P=0.004).The survival time of DLBCL patients with current HBV infection in 12 months was significantly lower than that of uninfected HBV patients at 66 months(P<0.001),and it was also significantly different from the survival time of patients with previous HBV infection(P=0.001).8.Univariate analysis showed that male sex,degree of clinical stage(Ⅲ/Ⅳ),and liver function damage during chemotherapy were related to poor prognosis.Cox multivariate analysis showed that age ≥ 60 years old,male,clinical stage(Ⅲ/Ⅳ),and abnormal liver function during chemotherapy are independent prognostic factors affecting patients with HBV lymphoma.Conclusion:1.48.8%(252/516)lymphoma patients were combined with viral hepatitis B infection,and current infection accounted for 12%(62/516);lymphoma patients were more likely to be infected with hepatitis B virus(including HBs Ag(+)and HBc Ab(+)),suggesting that HBV may play a role in the pathogenesis of lymphoma.2.Lymphoma patients with viral hepatitis B infection are older,the spleen is more susceptible,and the incidence of elevated transaminases during chemotherapy is higher.3.Patients with lymphoma who are infected with hepatitis B virus may activate hepatitis B virus during treatment and increase the mortality rate of hepatitis B.4.Concurrent hepatitis B infection is one of the poor prognostic factors for patients with lymphoma.In particular,current infection is a poor prognostic factor for B-NHL including DLBCL.